The economics of rural health insurance: the effects of formal and informal risk-sharing schemes in Ghana
Many households in Ghana are exposed to risks from preventable diseases, poor weather, and economic mismanagement but they have limited access to quality health care because of existing ineffective financing options, especially for the poor and people who live in rural areas. This study uses data from the two oldest community-based health insurance schemes in Ghana to investigate the role of this type of schemes on access to health care and health care expenditures. It also examined how the schemes cover the people who need the advantages of insurance most; poor people and high risk individuals, who would find it difficult to pay for health care in the absence of insurance. The findings reveal strong positive effects on access to quality health care but portray remarkable exclusion of the poorest of the poor. The study highlights the need for improved rural health infrastructure and stronger linkages between modern and traditional means of risk sharing to make the newly introduced national health insurance scheme in Ghana more effective and equitable.
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Overview of the health care system in Ghana and major financing
Concepts and economic theory of health insurance
Demand for rural health insurance
3 other sections not shown
adverse selection Asenso-Okyere attributes average Bamako Initiative benefit package Bivariate probit estimates characteristics Chi-squared test choice conjoint analysis consumption coverage cream skimming Dangme West District Distance to district district capital district hospital District West Gonja drugs economic effects of insurance equation formal health insurance formal schemes health care expenditures health care facilities health care seeking health care services health centres health insurance schemes health sector high-risk individuals hospitalisation household members independent variables informal groups informal health insurance Informal insurance group informal schemes inpatient insurance group 1A insurance hospitals insurance on health low-risk moral hazard multinomial logit Nkoranza District West Nkoranza sample non-insured Number of adults payment poor premium Probability Probability Probability providers reported ill respondents risk aversion rural health insurance scenarios schemes in Ghana seeking behaviour staff attitude StataCorp Table treatment cost West Gonja District World Bank